Last Updated on August 8th, 2019
America is an incredibly litigious society. Americans can and do sue each other for good reasons, bad reasons, and no reason at all. You don’t have to sue anyone you don’t want to, but knowing your rights in the doctor’s office can prevent situations where you might feel the need to assert your legal rights as a patient1, and might keep you from getting sued yourself.
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Many people who have acne spend a great deal of effort successfully concealing their condition. They may be very skillful in their use of cosmetics, or they may have had dermabrasion, skin peels, dry tattooing, laser resurfacing, or surgery. (You can read about all of these methods on this site.) The last thing patients want2 is for their privacy to be breached and their dermatologists holding them up to the world as an example of successful treatment.
But that is exactly what can happen to many acne care patients. Some physicians use before and after photos of their patients in their practice brochures or online. Some physicians have even “outed” their acne patients on Facebook and Twitter.
Federal privacy laws, more specifically HIPAA (the Health Insurance Portability and Accountability Act), place stringent limits on your doctor’s ability to disclose3 even that you are his or her patient. This means that your doctor probably will not “friend” you on Facebook, because you would then have access to the doctor’s other connections on Facebook.
If your doctor requests a Facebook friend connection, and your only connection is as a patient, you should decline, sending your doctor a brief explanation. It is all too easy for a careless comment on Facebook by your doctor to let all your Facebook friends know what kind of treatment you are getting. Connect to your acne doctor on Facebook through the doctor’s Fan Page, if at all.
Officials of the US Federal Communication Commission are quoted as saying that if you send your doctor an email, you are giving your doctor implied consent to respond to your email without encrypting it. This means that if you, for instance, emailed your doctor a question about whether your husband need to wear a condom while you were changing your IUD so you could take Accutane, the doctor is not liable for any email security problems that may arise4 when the reply is sent.
A reality of acne scar treatment in the USA is that it is very expensive and there is no public program that pays for it. Unless you have a very high-end (and probably extremely expensive) private health insurance policy, you will probably have to pay for office visits, medications, lab tests, and skin treatment procedures out of your own pocket.
That doesn’t mean that your doctor won’t be able to get initial approval to start your treatment from your insurance company. What often happens is that the insurer tells the doctor that your treatment will be covered so you might only be asked, say, for a $35 copay on a $500 to $1000 visit. Then several months later, after you have had three or four $500 to $1000 visits to the skin care doctor, your health insurance company rescinds the authorization and the doctor tries to collect from you.
The only likely exception to this rule occurs when an acne scar interferes with some function, such as some scars around the eyes. Most insurance companies will also pay for treatment of scars caused by acne conglobata, but not for scars caused by acne keloidalis nuchae. In any case, as the patient’s bill of rights states5, you have the right to access an easily understandable summary of your coverage and benefits.
Active acne treatment, that is, treating pimples, blackheads, and whiteheads, is also very expensive in the United States, but more health insurance policies will pay for it. If you had acne before you got your health insurance and you did not disclose the condition on your application, however, the insurance company may deny payments or even cancel your coverage. Health insurance you get through the new federally funded health insurance risk pools, however, covers pre-existing conditions.
Doctors understandably get upset when they are criticized online. If you make statements that are critical of your doctor6, harm your doctor’s business, and you can’t back up, you may find yourself defending a suit for defamation.
Different states have different rules about posting information about doctors. A new law in Texas, for example, makes it a crime to post comments about a Texas doctor anonymously. Laws in some states require the doctor to take any legal action for slander in just one year in New York, but you could be sued by your doctor as long as 15 years after the fact in Ohio.
In New York and Connecticut, federal appeals courts cases establish the date a statement is made as the first day it is posted on line, and require any plaintiff to file a suit within a specified number of years, one year in New York, two years in Connecticut. In the rest of the United States, however, the Internet is considered to be “perpetual,” that is, you could be sued at any time for the rest of your life.
Don’t make your life complicated. If your doctor doesn’t do a good job, just move on. You might warn your friends and family, but don’t create an electronic trail of criticism that might cause your acne care provider to take legal action.
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